It’s no secret that those who benefit from an expensive education are disproportionately represented in certain professions. Despite private schools only educating around 7% of British children, a report by the government’s Social Mobility Commission found that the majority of doctors, lawyers, barristers and journalists attended private school.
If anything, the disparity is increasing. The same report also found that for medical students at UK universities, the proportion coming from a private educational background has increased from 51% in 1987 to 61% in 2016.
No single factor can account for the lack of students from disadvantaged backgrounds studying medicine at university level with a complex and often overlapping set of challenges stopping talented students from becoming doctors. As early as year 8, a wrong choice of GCSE subjects can dash any hopes of getting into medical school.
In schools that do not have the funding to provide extra support to help students prepare for the relatively complex application process for medical schools, even those pupils who show a great deal of potential can easily fall behind. These reasons all contribute to the fact that 80% of medical school applicants come from just 20% of schools, and 80% of successful applicants come from higher professional or managerial social classes.
Throughout his time at medical school, Dr Brian Wang saw the real-life impacts of the gap between people who require health care services the most, who are often from deprived or disadvantaged backgrounds, and doctors who are far more likely to come from a privileged set of circumstances.
“When Covid happened we were hearing about people from certain backgrounds not wanting to engage with the vaccine vaccination programme – there was a real disparity between the communities the NHS is meant to serve, and the people that are involved in healthcare,” says Brian.
In the summer of 2020, he started digging into statistics around medical disparities and decided now was the time to do something that would support students from disadvantaged backgrounds into leading medical schools across the country.
Initially, the plan was just to start a mentorship programme, with Brian asking his friends from medical school if anyone wanted to mentor disadvantaged children and then pairing them with pupils from underperforming schools. But the idea took off far more quickly than he could have expected, as fellow medics jumped at the chance to give back. In2MedSchool, a community interest company driven to widen access into medicine in the UK, was born.
“It just blew up; it became a massive, massive thing overnight. Over the next couple of weeks and months, the numbers just went up almost exponentially. By the end of the first academic year, we had about 1,200 people that were actually matched. And now, about 20 months since then, we’ve reached 2,000 disadvantaged students,” adds Brian, who is a full-time doctor at the Imperial College Healthcare NHS Trust on top of running In2MedSchool.
“We even had someone who told us that she’d been homeless for the last two years. But with our help, she’s got to study at Imperial.”
Paying it forward
Like many of the future doctors Brian mentors and supports, his own background was markedly different from many of his university peers. He moved to a council house in the UK at six years old. Struggling with his English and needing extra support during primary school to catch up to other students, he nonetheless held onto his goal of studying medicine at university. Despite not having any support during the application process, he was accepted and studied at University of Cambridge and Imperial College London.
Brian and the other medical students and junior doctors who offer free mentorship cover what it’s like to be a doctor, all aspects of the application process, including interview prep, preparing for the admissions tests and help with personal statements.
Yet, unlike other widening participation schemes, In2MedSchool mentors also talk about the practical aspects of going to university that many students have questions about but may not know who to ask, such as dealing with mental health issues and exploring what it’s like to leave home for the very first time.
Some of the mentees have come through the care system, are estranged from their families, are seeking asylum or attend schools that are too small to attract the attention of university-run widening access schemes.
“We are doing our best to reach out to the kids in schools that typically don’t get reached out to from participation initiatives,” adds Brian.
Medical schools and universities across the country are making efforts to level the playing field for underprivileged students by ensuring that personal statements are not scored higher than UCAT scores (based on an admissions test for medical schools in the UK) and interviews.
However, as Adilla Allebone-Parish, Programmes Director at The Armitage Foundation, a charity that works to increase the number of medical students from underrepresented backgrounds, explains the “availability of paid interview coaching and UCAT courses means that those with access to more money and knowledge are still at a clear advantage to lower income applicants.”
Adilla also points to the longstanding belief that only certain types of people become doctors and that those from underrepresented groups wouldn’t fit into these professions.
“This means that there is a general lack of aspiration, with people from these backgrounds who are drawn to healthcare choosing less ambitious (but equally valuable) career paths,” she adds.
For Dr Sanjid Seraj, a Core Surgical Trainee in the West Midlands who has been mentoring since last August for In2MedSchool, the students he supported faced specific challenges around how to act in interviews and articulating how their past experiences could be used in their medical school applications.
For example, Sanjid mentions the case of a mentee who worked at McDonald’s for a year but wasn’t sure how to translate this experience to their medical application.
“Working in McDonald’s is tough work but you learn a lot of skills around team working, leadership; things that are useful when you’re a doctor. There are so many factors that make you a good doctor like compassion and communication skills that you can gain from other experiences,” he explains.
If it wasn’t for the support offered by In2MedSchool, thousands of the most talented but disadvantaged students would either lack the confidence to apply to medical school or not have the right support to make a strong application.
“If you don’t see representation, you don’t trust the doctors and then there’s going to be issues with compliance to things like medication. The overall standard of care, I believe, is affected by a lack of representation,” adds Brian.
A lack of genuine support for disadvantaged young people not only has the potential to leave these students to choose other careers but the healthcare sector loses out on skilled staff who can connect with the communities they would serve as doctors.
“The long-term aim is to encourage representation. If plenty of very smart individuals from disadvantaged backgrounds are just given the chance, they will be fantastic doctors.”